A Broken Mental Health System: Medicate, Release, Repeat

The mental healthcare crisis in America demands our immediate attention. We're witnessing a disturbing pattern where individuals with documented histories of serious mental illness cycle through brief institutional stays, only to be released back into society without adequate support systems—often with devastating consequences.

Common reasons for institutionalization (multiple sources): 

– Severe depression

– Suicidal behavior, thoughts, or threats

– Schizophrenia

– Hallucinations or delusions

– Lack of sleep or food intake for several days

– Severe substance abuse issues

– Inability to meet basic needs like eating or bathing

– Ineffective response to previous medications and therapies

Source 1: 

https://pmc.ncbi.nlm.nih.gov/articles/PMC10338701/pdf/10.1177_00207640221143282.pdf

In summary, this article explores the recent change (over last several decades) in treatment pf psychiatric patients from long term hospitalization to short-terms stays and/or outpatient services. 

Noteworthy points/findings:

-"Revolving door" (RD) treatments tend to impact a patient group that is younger, single, unemployed, of low education level (less than a high school degree), and with diagnosis of a psychotic disorder.  Many of these characteristics would mark a patient "at risk" and yet they're receiving inadequate revolving door treatment. 

-This shift to revolving door treatment is partially attributed to improvement in community-based/outpatient services. 

-Definition of revolving door patients: those patients requiring a large amount of mental health derived resources (20-30%), thought they represent less than 10% of the total number of patients (small populations requiring a sizable amount of service)

-The research efforts to specifically identify the factors leading to multiple hospitalizations has been controversial, but these authors offer a systematic review to analyze existing research on the topic and forecast the types of patients who will likely receive RD treatments and risk ongoing rehospitalization.  

-The studies reviewed in this article have some different and conflicting findings, but there were some common observations:

*RD phenomenon is greater in younger age groups (esp among those between 15-45 years old)

*No particular gender is associated with RD phenomenon.

*No particular ethnicity is associated with RD phenpmeon. 

*RD treatments seems to occur more frequently in urban areas, as opposed to suburban or rural areas. 

*RD seems to occur more in single or unmarried patients as opposed to married patients. 

*It has been commonly noted that family plays a significant role in RD treatments; patients with family conflict often fall into the RD population, where patients with supportive family are more likely to require non-heavy use of psychiatric services. 

*RD seems to be heavily associated with patients who are unemployed or receiving disability pension. 

*RD patients were significantly likely to have been diagnosed with schizophrenia, personality disorder, or alcohol/substance abuse 

Source 2:

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Chapters

• 0:28 Introduction to Important Topic
• 1:39 Levels of Mental Illness Explained
• 2:55 The Revolving Door Problem
• 4:53 Medication Without Proper Solutions
• 7:26 Proposing Lifelong Monitoring Solution
• 8:32 Introducing Research Findings

Transcript

Speaker 1: 0:17

okay, great to be back again. Guys. I have a topic here today I've been waiting to bring forward to you. This topic is a need and nobody's really addressing on it we're about to talk about. But someone needs to do something and say something, because people are taking advantage Businesses are taking advantage for the sake of money, for the illnesses and weaknesses of others. So to clarify where we're going with this today, I want to be glad to be here, glad you are here and from this point on let's hop right into it. Today's topic we're going to cover mental illness.

Speaker 1: 1:34

Mental illness and we have some issues with mental illness and I want to bring it to light. First off, when we have someone who's mentally ill, we have to analyze them a certain way. We just can't look at every mentally ill person the same way because there's levels of them. There's levels of mentally ill. In somebody's book, I might be classified as mentally ill, but the point still remains there's different levels of mental illness. I might be classified as a functional mentally ill person, but once again, there are different levels of mental illness. I bring that to you because lately, in the past several years, we've been having a lotbing people in broad daylight, right in front of other people Not to say that the way to do it is in the dark, but I'm just saying there's no. You know there's no. How do I put it? It's just reckless behavior. I guess that's the best way to say it. It's just a lot of reckless behavior. And then, once the person gets caught if they're caught what do we hear next? Oh, this person has a history of mental illness, which now leads me to the next point. You know, the person has a history of mental illness, has a history of mental illness. That means they have already been seen by some form of psychologist or doctor, or even been inside of a mental institution already. So my question is now why is this person back on the street if they're mentally ill?

Speaker 1: 4:41

Mental institutions are not curing the problem. You're not fixing anything. What do you do? You dope them up with some sort of medication which somebody's making a fortune on on the back end that in society today we find that, hey, whatever works, you're going to even try and make money off of someone that can't fend for themselves, someone that is actually mentally ill. You're going to dope them up, keep them in a mental institution. For what? 30, 60 days, depending on whether or not it's a voluntary situation or involuntary situation, and then you need some form of court order to extend that. But after it's all said and done, what happens? You release this person who has been diagnosed as having some form of mental illness and you release them back to the street and then they commit another crime or do something heinous and somebody else's life is lost. You put them in a mental institution. They're unable to stand trial because they've been diagnosed as schizophrenia or whatever the case might be and then you put them back on the street.

Speaker 1: 6:39

It's a revolving door, told me. Never present a problem without presenting some form of a solution. Okay, my idea of a solution we need ongoing lifelong monitoring of someone who is diagnosed as having some form of mental illness that is not able to function in society. This is what is needed. I have some work, some research, I looked up, and also I have additional assistance from a friend of mine who also did a lot of research on this topic, because it's a touching topic and I think other people can see where we're coming from when we discuss this, so give me a second here and I'll be right back at you. Let me hit you with some factual data on this mental illness. Stand by, we'll be right back.